Sixteen year-old Matthew* had a sad and embarrassed look on his face as he sat in my waiting room on the day after an overdose and a few hours at the ER. The parents appeared both perplexed and scared as they spoke of their son as "the kid who had everything going for him." He was bright, tall, and athletic, but virtually drained of the energy that often characterizes teens. Until recently, his grades had been A's and B's at an excellent private school and he had been a starter on his football team. He was popular with his peers and well liked by his teachers.

My initial thought was that the suicide attempt didn't make any sense... but I quickly reminded myself that everything eventually makes sense when we know enough.

It didn't take long to diagnose major depression. His sadness was pervasive, he'd been considering suicide for several weeks, his grades had dropped and he couldn't concentrate. He sometimes awoke at night and couldn't fall back asleep. Despite having many friends, he didn't want to go out or do anything. His parents noted that he'd been "edgy" and "constantly irritable." He told me that his appetite was "okay," but his mom noted that he had lost weight. I learned that several relatives on his father's side of the family had suffered from mood disorders.

Matt's depression was textbook perfect, but there was nothing perfect about its impact on Matt or his family. Matt traced the start of his depression to a conflict with his girlfriend, but noted that it got worse when his inability to catch a pass in the last minutes of a football game resulted in the loss of a chance to go to the playoffs. He didn't know if his worry caused his sleep problems or if insomnia was robbing him of the energy to concentrate on school work, but it seemed like everything was ganging up on him and he felt like giving up. He was anxious that his mother's job was in jeopardy. Toward the end of the session, Matt said that he was fearful that his girlfriend was pregnant. He felt ashamed and overwhelmed. The puzzle was coming together - all behavior does fit the circumstances that surround it.

In working with teen depression, we need to build on strengths and fix what's wrong.  CLICK HERE to read the Dr. Rohde's full article and tips for dealing with teen depression.

 

Licensed Psychologist